This is a planned competing renewal of the Principal Investigator's K24 Midcareer Investigator Award in Patient-Oriented Research (K24 MH01557-05). The overall scientific objectives of this award are (1) to evaluate the effectiveness and safety of treatments for children and adolescents with major mental illness and (2) to recruit and train junior scientists in the methods and applications of clinical trials in pediatric psychiatry. The initial K24 award, which was focused on anxiety disorders and, more generally, on comparative treatment trials and clinical trials methods, ends in 2003. During this period, Dr. March will have published more than 100 manuscripts; successfully concluded two and launched three (and perhaps as many as five) NIMH-funded clinical trials; developed methodological expertise unusual for a child and adolescent psychiatrist; and successfully mentored more than two dozen junior and mid-career investigators. Thus, Dr. March more than filled the primary aims of the K24 Program Announcement, which emphasizes scientific productivity in patient-oriented research and mentoring activities. This competing continuation application sets out research, didactic, and mentoring agendas designed to make clear the added value of the K24 award. The research agenda includes treatment outcome studies in ADHD, depression, suicide, anxiety disorders, and OCD, with particular attention to the role of the K24 in facilitating secondary analyses. Serving the research agenda, the didactic agenda provides for training in the SAS programming language, neuroimaging, and psychiatric genetics. The mentoring agenda provides for ongoing and new mentoring/consultative activities and for leadership in the area of research workforce issues in child and adolescent psychiatry. By providing stable salary support at 100% effort uninterrupted by non-research patient care and administrative duties, the K24 competing continuation will sustain and promote practical and theoretical contributions to the diagnosis and treatment of mentally ill children and adolescents.